Decline of serologic immunity to diphtheria, tetanus and pertussis with age suggested a full life vaccination in mainland China

ABSTRACT

Background: Diphtheria-tetanus-pertussis (DTP) vaccine has already been involved in national vaccination program for several decades in China. The immunity against these diseases in the people of all ages is not well investigated.

Materials and methods: Serum samples were tested for IgG antibodies to diphtheria toxoid (DT), tetanus toxoid (TT) and pertussis toxin (PT) by using commercial ELISA kits.

Results: A total of 666 sera of patients from 1 day to 89 years of age was collected from 2018 to 2019. The protective rates of diphtheria, tetanus and pertussis were 45.5%, 54.4% and 4.7%, respectively. Only 4.7% of the study population had seropositivity against three of the diseases. Young infant (<3 m) and adult (>18y) were generally lack of protective antibody against diphtheria (81.7% and 58.3%) and tetanus (91.5% and 86.2%). An obvious increase in immunity level of diphtheria and tetanus was observed at 3 m-3y, but there was no significant increase of immunity to pertussis at any age group. All age groups showed low immunity to pertussis.

Conclusions: The present results revealed the susceptibility to diphtheria and tetanus in young infants and adults, and the susceptibility to pertussis over the ages, which highlight the need to improve the current vaccination program.

KEYWORDS:

• Pertussis
• diphtheria
• tetanus
• seroprevalence
• vaccination

Acknowledgments

We thank all patients and their parents who made this work possible, and all study clinical staff at Youyang County People’s Hospital, Chongqing, China.

Author contributors

Kaihu Yao, Changhui Chen conceived and designed the study. Dandan Liu, Xiaoping Cheng, Shi Wei, Lin Yuan did the clinical samples collection and performed the experiments. Dandan Liu, Kaihu Yao analyzed the data. Dandan Liu wrote the first draft of the manuscript and Kaihu Yao and Changhui Chen revised the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [81973100]; the Beijing Natural Science Foundation and the Haidian Original Innovation Joint Fund in 2019 [19L2041].